'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

The day the DH got roasted over seven-day services ... and other stories

Readers of this column will know that Sick Notes is not partial to politicians, but during a recent hearing of the Public Accounts Committee an MP proved he was worth every penny of taxpayers’ money.

Showcasing a laconic Lancashire charm that they definitely don’t teach at Eton, Conservative MP David Mowat managed to reveal just how little DH officials know about what a seven-day service will cost.

Mr Mowat asked whether they had estimated how much funding was needed for a seven-day service. ‘Er, we do not estimate it that way,’ said Charlie Massey, director-general of strategy and external relations at the Department of Health.

‘But,’ Mr Mowat said, ‘surely you know how much the junior contract may cost?’

‘It is important to look at the whole of the contractual environment in thinking about that,’ said Mr Massey, growing redder in the face.

‘It does not give a great feeling that you understand the implications of the policy in terms of manpower,’ said Mr Mowat.

‘I wish it was a question that could be answered in a simple and mechanical way…’ bumbled Mr Massey.

‘Right, but if you don’t know the answer approximately…’

‘It differs so substantially from one local health economy to another.’

And then the killer punch. ‘Yes, but you are the guys sitting above all of these trusts. I am surprised that you can put this policy in place without having some idea of the implication for staffing levels, cost or budget – that is, after all, what today’s hearing is about.’

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It must be a hard job being health secretary. People expect that you have some knowledge of medical matters as you are in charge of the health service.

Mr Hunt was perfectly correct that it may be a ‘much quicker way’ of reassuring yourself that your child does not need NHS care and you can attend that cocktail party or travel to the gîte in Normandy. How was he to know that a rash could be meningitis? I mean, the man is only making vital decisions on the future of the NHS on a daily basis.

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It is rare that a report from a think-tank makes Sick Notes laugh out loud, but this one from the Euro Health Consumer Index (no, we hadn’t heard of them either) is a real corker.

It says the NHS is the 14th best health system in Europe, slightly ahead of Croatia and Slovenia. It says patients wait too long to see a GP, to be treated in A&E and to have a CT scan for something serious like suspected cancer… blah blah blah. But skip to page 11 if you want to spit tea on your monitor.

‘The UK healthcare system has never made it into the top 10 of the EHCI, mainly due to poor accessibility and an autocratic top-down management culture. The country that once created the Bletchley Park code-breaking institution would do well to study the style of management of professional specialists created there.’ Miaow.

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Even the mightiest can be brought down by a single tweet. Department of Health mandarins recently found themselves ridiculed for tweeting the following: ‘From 2020 patients will be given definitive cancer diagnosis or all-clear within 28 days of urgent GP referral.’

‘This is wild,’ said one GP. ‘Wow! That’s clever. You do know medicine doesn’t work like that, don’t you?’ said another.

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PR fail of the month. The spin doctor who asked whether Pulse would like to publish an advice article on how GPs can ‘advise patients on their travel insurance’. That press release went straight in the bin.